Applicants stuck in MNsure's gears

Jim Mone, APNov. 13, 2013: Maureen O'Connell addresses people in attendance at the "MNsure Crash Course" at the St. Paul Library to help them understand how federal health care reform affects their lives.

Laurie Swenson quit her editing job with the Bemidji Pioneer to care for her ailing parents, counting on getting affordable health insurance through the state's new MNsure exchange.

The 56-year-old completed her application on Oct. 16. She waited for the status to change from "pending" so she could complete enrollment in a health plan.

As of Monday — just a week before the deadline to get benefits that start on Jan. 1 — Swenson's application was still listed as pending.

"I didn't think anything of it for a while," she said. "But it's getting close to the deadline."

More than two months after the online exchange's launch, a stew of glitches, quirks and backlogs have left people waiting weeks to complete their applications and select health plans.

The delays help explain why MNsure's latest publicly available numbers showed 50,799 accounts opened on the website through November, but only 32,209 applications completed and only 24,586 people who selected plans and whose enrollments were being finalized.

The issue could get more complicated for MNsure, which was created under the federal health law to cover the uninsured and improve benefit options for people who aren't covered by employer plans. Officials expect a surge of applications by procrastinators this week, while applications filed months ago are still in process.

"This is something that we have been hearing about for some consumers, and this is something we have been attending to and watching for the last couple of weeks certainly," MNsure spokeswoman Jenni Bowring-McDonough said. "To be fair, we also have had people who have been pending who are coming through now."

Then on Monday the login page went down about 7:45 a.m. It was back up within an hour and a half, but trouble struck again when applicants discovered that Feb. 1 was the only start date listed. Officials expected to have that problem "remedied yet tonight."

Updated enrollment figures to be released at a MNsure board meeting on Wednesday will indicate whether the gap between people wanting insurance and actually receiving it has closed.

MNsure officials said no one problem explains the delays. For example, Swenson's "pending" status could be related to the federal systems used to verify identity or income. Inaccurate information entered by the applicants could also be to blame, Bowring-McDonough said.

The delays have made the insurers who sell health plans on MNsure anxious, because they are supposed to provide benefits starting Jan. 1 to customers they still haven't identified. Some people have called to schedule medical procedures, only to find the insurer had no record of them.

In a Dec. 6 letter, the Minnesota Council of Health Plans reported problems even on approved MNsure applications. Some insurers received inaccurate or incomplete information about enrollees — missing apartment numbers, for example. That delayed their ability to send out invoices to customers paying online or bills to those who elected to pay by mail.

Geoff Bartsh, Medica vice president of public policy, said his biggest concern is that the focus has been on workarounds, while the root of the problem "isn't even close" to being addressed.

"We're creating a lot of backroom fixes to make sure the information gets where it needs to go and can be loaded," he said. "But it's a lot of duct tape and toothpicks and putting salt packets under a crooked table."

Bartsh said the insurer's call center is being swamped with people who are "rightly worried" that their coverage hasn't been confirmed. Those who have enrolled and made a payment through MNsure can rest assured that they will be covered, he said, even if they haven't yet been notified.

"Your coverage will be recognized even if you're lost in the system today and we don't find you for a couple of weeks," he said. "No one's going to hold you accountable for glitches at our end."

Broker Heidi Michaels said she has started advising clients to keep current health plans and try in January to log back into MNsure for coverage starting Feb. 1.

"We're kind of reaching panic status now," said Michaels, who works at the Dyste Williams agency in St. Louis Park. "There's just no time left. No time to send invoices, no time to send in payments, there are different deadlines for MNsure and the carriers. Even getting a question answered is almost impossible because wait times are so long at the call-in center."

To try to resolve the issues, IT specialists have been meeting daily at MNsure. But it still involves entering and checking ­information by hand.

"When we know someone has chosen us, they're getting enrolled promptly … It's not as though everything is in a big queue-up," said Andrea Walsh, HealthPartners executive vice president and chief marketing officer. "One of the challenges is to reassure people to be patient and call back."

Swenson, who is uninsured now, is getting nervous. Twice she suffered falls that required medical observation. One arm still has problems, and she acknowledges she probably would have received treatment for it already if she had insurance.

Some people have advised her to cancel the pending application and start over. But she sees that as a last resort.

"I was just wary of doing that because I don't know for sure if that is the right thing to do," she said. "And it took me hours to to do in the first place."

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